eMedicine Specialties > Dermatology > Allergy & Immunology

Atopic Dermatitis: Follow-up

Author: Bernice R Krafchik, MBChB, FRCPC, Professor Emeritus, Department of Pediatrics, Section of Dermatology, University of Toronto
Contributor Information and Disclosures

Updated: Oct 16, 2008

Follow-up

Further Outpatient Care

  • Monitor atopic dermatitis (AD) patients frequently.
  • Reinforce therapeutic regimens with patients.

Inpatient & Outpatient Medications

Deterrence/Prevention

  • Moisturization is important on an ongoing basis and may prevent flares.

Complications

  • If topical corticosteroids are used inappropriately or if superpotent steroids are used in teenagers during rapid growth, striae may occur. Skin thinning can result if steroids are used inappropriately in older patients.
  • Whether verrucae vulgaris and mollusca contagiosa are more frequent is difficult to assess, but they are more widespread and difficult to eliminate.
  • Tachyphylaxis to topical steroids occurs if they are not used on a stop-start basis.

Prognosis

  • Most patients improve; this can occur at any age. While the frequency of AD is as high as 20% in childhood,15 it is 0.9% in adults.
  • One third of patients develop allergic rhinitis.
  • One third of patients develop asthma.

Patient Education

  • Frequently reinforce treatment and maintenance regimens with patients.
  • Advise patients to contact the National Eczema Association for Science and Education at 4460 Redwood Hwy, Suite 16-D, San Rafael, CA 94903-1953.
  • Inform patients that treatment does not produce cure but good control can be achieved
  • Show videos to patients that show how to apply medication and that discuss the role of moisturization.
  • For excellent patient education resources, visit eMedicine's Skin, Hair, and Nails Center. Also, see eMedicine's patient education article Eczema.

Miscellaneous

Medicolegal Pitfalls

  • Failure to explain the adverse effects of topical steroids to patients may result in medicolegal problems.

Special Concerns

  • Other children in the family may develop AD.
  • Patients may develop acute food allergies (eg, to peanuts and/or eggs). Epinephrine injectors (EpiPen, EpiPen Jr) should be available.
  • Patients may develop a generalized reaction to herpes simplex virus (eczema herpeticum).
  • One third of patients develop asthma, and one third develop allergic rhinitis.
 


More on Atopic Dermatitis

Overview: Atopic Dermatitis
Differential Diagnoses & Workup: Atopic Dermatitis
Treatment & Medication: Atopic Dermatitis
Follow-up: Atopic Dermatitis
Multimedia: Atopic Dermatitis
References
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References

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Further Reading

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Keywords

atopic dermatitis, eczema, infantile eczema, Besnier's prurigo, intrinsic eczema, extrinsic eczema, atopiform eczema, asthma, food allergy, peanut allergy, allergic reaction

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Contributor Information and Disclosures

Author

Bernice R Krafchik, MBChB, FRCPC, Professor Emeritus, Department of Pediatrics, Section of Dermatology, University of Toronto
Bernice R Krafchik, MBChB, FRCPC is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, Canadian Medical Association, College of Physicians and Surgeons of Ontario, Royal College of Physicians and Surgeons of Canada, and Society for Pediatric Dermatology
Disclosure: Nothing to disclose.

Medical Editor

Peter Fritsch, MD, Chair, Department of Dermatology and Venereology, University of Innsbruck, Austria
Peter Fritsch, MD is a member of the following medical societies: American Dermatological Association, International Society of Pediatric Dermatology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Van Perry, MD, Assistant Professor, Department of Medicine, Division of Dermatology, University of Texas Health Science Center
Van Perry, MD is a member of the following medical societies: American Academy of Dermatology and American Society for Laser Medicine and Surgery
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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